Official 2024-2025 Allergy & Immunology Application Thread

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Deecee2DO

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Here we go! Its that time of year again. Figured I’d get this started. Good luck yall

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Literally was about to start this thread myself, glad you jumpstarted it. Nervous but excited to apply soon!
 
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Here we go! Its that time of year again. Figured I’d get this started. Good luck yall
Wait, I thought you wanted to do GI? What made you switch to allergy?
 
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Wait, I thought you wanted to do GI? What made you switch to allergy?
I was on the fence in med school between the 2 but had all allergy research at the time did a GI rotation in residency and hated it haha. I love everything about allergy def the specialty for me
 
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I was on the fence in med school between the 2 but had all allergy research at the time did a GI rotation in residency and hated it haha. I love everything about allergy def the specialty for me

Would love to hear more details about the switch if you don't mind. Always curious for why people go into their specialty.
 
Would love to hear more details about the switch if you don't mind. Always curious for why people go into their specialty.
yeah! I honestly liked outpatient/chill side of allergy zero weekends 4 day work weeks i like more cerebral than procedures and love the bread and butter of allergy while rotating on the service. Kids and adults acute and chronic path see quick results for many of the patients and drastic improvements in quality of life. the patient polulation are relatively happy and healthy. allergists are generally a chill bunch and laidback like myself especially in pvt practice. u do at times have the opportunity to see some weird stuff and have to do some detecive work. Allergy also by far has the best balance of good income/lifestyle of the non-procedural IM subs aside from hemeonc. if I did want to do procedures, I do have the option to do rhinoscopy especially those who train at USF where they get a lot of reps with this. we can do them but some dont bc they dont feel comfortable with liability and would rather send to ENT but theres opportunity to learn it and incorporate in pvt if one wants to
 
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yeah! I honestly liked outpatient/chill side of allergy zero weekends 4 day work weeks i like more cerebral than procedures and love the bread and butter of allergy while rotating on the service. Kids and adults acute and chronic path see quick results for many of the patients and drastic improvements in quality of life. the patient polulation are relatively happy and healthy. allergists are generally a chill bunch and laidback like myself especially in pvt practice. u do at times have the opportunity to see some weird stuff and have to do some detecive work. Allergy also by far has the best balance of good income/lifestyle of the non-procedural IM subs aside from hemeonc

Yep, would totally choose allergy if I had to choose a medicine subspecialty. Closest to derm outside of heme onc (cancer = hard pass), but also has good outcomes and healthy pts like you said. Only thing that would make me intimidated is all the immuno stuff. Hated that crap in school.
 
Yep, would totally choose allergy if I had to choose a medicine subspecialty. Closest to derm outside of heme onc (cancer = hard pass), but also has good outcomes and healthy pts like you said. Only thing that would make me intimidated is all the immuno stuff. Hated that crap in school.
Honestly pvt practice is mostly allergy which is great for me. Much of Immuno is academics not really my vibe
 
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Hi everyone, second year fellow here. I remember the stress and excitement of applying for A&I fellowship. Happy to answer any questions. Good luck!
 
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Hi everyone, second year fellow here. I remember the stress and excitement of applying for A&I fellowship. Happy to answer any questions. Good luck!
hey! Can you comment a bit about how your job search is going? How are starting salaries, earning potential, job avaibility etc.?
 
Anyone know off hand which programs have heavy inpatient services as apart of their training?
 
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hey! Can you comment a bit about how your job search is going? How are starting salaries, earning potential, job avaibility etc.?
Hi, this is a great question and I encourage everyone to think about your ultimate goal post-fellowship.

I am in the mist of interviewing as many people as I can to get as much information regarding post-fellow employment. Here is what I have gathered so far.

1. Work setting. There are academic vs private vs mixed careers. Mixed career is becoming more popular as academic does not pay enough money but private practice allergists miss being a part of academia (some love teaching, working with residents/fellows, or staying up-to-date on research stuff). Mixed practice is also getting a lot of private industry attention because it is easier to do clinical research in private practice (less red tape when it comes to IRB/grant vs academic institution). You can do that too in academic, but it is really tough financially because the institution takes a cut of your grant/funding. Within academic, there is basic science, clinical, and medical education tracks---which can vary highly in terms of your day-to-day and salary. For example, a basic scientist may have one half day of clinic where as a clinical will have 3-4 days. People in medical education tracks (+/- clinical) are usually the PD/APDs and they do it because they love teaching because....medical education unfortunately is not highly valued from a financial standpoint and they are paid less (love your PD/APDs, they truly are not there for the money).

2. Salary. This is perhaps the biggest difference. I am still learning this process but most people are paid by RUVs. An example that was provided for me was in private practice (PP), one single skin prick can be $5-10 and in academic, that same single skin prick is worth $0.60. So, if you do a full environmental panel in PP, it could get you $500 (50 pricks * 10) and in academic it will get you $30 (50 pricks * 0.60). Another example would be allergy shots. In PP you can make 2-3K annually per allergy shot in academia...depending on your institution...you may just get paid for writing the prescription...not the allergy shots themselves which is like....one RVU. Another example would be spirometry in PP can be $100, it could be $0.17 in academia.

Now, there is an "eat what you kill" culture in PP. You have to hustle. That is, you may or may not have a base salary in PP (which will likely be low) and your salary is highly dependent on how many patients you have on procedures/shots. There are PP allergists out there making close to one million a year but these are the alphas who own their own PP and they have been in the game for a long time. But, they started exactly where you were.

So why in the world would you stay in academia given such a huge difference in salary?
1) There are situations where you HAVE to stay: you love basic science (unless you can go into industry), you have PSLF, job opportunities in specific cities, you love teaching

A different pay system is Kaiser. Kaiser physicians are salaried and their take home is not RVU dependent. Your earning potential is limited to the salary plus some bonuses, but it will not likely get your to higher tax bracket near the >$500K.
1. Starting SF allergist salary is $278,000 (source: Allergist Opportunity- San Francisco, CA - San Francisco, California job with Kaiser Permanente - The Permanente Medical Group, Inc. -Northern California | 110442111)
2. Starting LA allergist salary is $314,000 (source: Allergist - Full Time Opportunity - Bakersfield, California job with Kaiser Permanente – Southern California Permanente Medical Group | 110408574)

Now, this is an incredible amount of money but as you consider your loans, your sacrifices, the VALUE you provide, and post-tax take home, it may not get you to the personal life goals you aspire to obtain.

Some additional resources I would recommend:
1. ACAAI career center - https://jobs.acaai.org/
2. Uni of CA salary - provides you with each academic salary - just search up their names - please do note that it only goes to 2022 which was in the midst of a pandemic AND jobs the physician did outside of their institution is NOT included - Compensation at the University of California: Annual Wage
3. California Paycheck Calculator - SmartAsset - punch in what a $300K take home salary would be in CA, it might surprise you

I will update as I speak with more individuals in the near future. Happy to help answer any other questions.
 
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Hi, this is a great question and I encourage everyone to think about your ultimate goal post-fellowship.

I am in the mist of interviewing as many people as I can to get as much information regarding post-fellow employment. Here is what I have gathered so far.

1. Work setting. There are academic vs private vs mixed careers. Mixed career is becoming more popular as academic does not pay enough money but private practice allergists miss being a part of academia (some love teaching, working with residents/fellows, or staying up-to-date on research stuff). Mixed practice is also getting a lot of private industry attention because it is easier to do clinical research in private practice (less red tape when it comes to IRB/grant vs academic institution). You can do that too in academic, but it is really tough financially because the institution takes a cut of your grant/funding. Within academic, there is basic science, clinical, and medical education tracks---which can vary highly in terms of your day-to-day and salary. For example, a basic scientist may have one half day of clinic where as a clinical will have 3-4 days. People in medical education tracks (+/- clinical) are usually the PD/APDs and they do it because they love teaching because....medical education unfortunately is not highly valued from a financial standpoint and they are paid less (love your PD/APDs, they truly are not there for the money).

2. Salary. This is perhaps the biggest difference. I am still learning this process but most people are paid by RUVs. An example that was provided for me was in private practice (PP), one single skin prick can be $5-10 and in academic, that same single skin prick is worth $0.60. So, if you do a full environmental panel in PP, it could get you $500 (50 pricks * 10) and in academic it will get you $30 (50 pricks * 0.60). Another example would be allergy shots. In PP you can make 2-3K annually per allergy shot in academia...depending on your institution...you may just get paid for writing the prescription...not the allergy shots themselves which is like....one RVU. Another example would be spirometry in PP can be $100, it could be $0.17 in academia.

Now, there is an "eat what you kill" culture in PP. You have to hustle. That is, you may or may not have a base salary in PP (which will likely be low) and your salary is highly dependent on how many patients you have on procedures/shots. There are PP allergists out there making close to one million a year but these are the alphas who own their own PP and they have been in the game for a long time. But, they started exactly where you were.

So why in the world would you stay in academia given such a huge difference in salary?
1) There are situations where you HAVE to stay: you love basic science (unless you can go into industry), you have PSLF, job opportunities in specific cities, you love teaching

A different pay system is Kaiser. Kaiser physicians are salaried and their take home is not RVU dependent. Your earning potential is limited to the salary plus some bonuses, but it will not likely get your to higher tax bracket near the >$500K.
1. Starting SF allergist salary is $278,000 (source: Allergist Opportunity- San Francisco, CA - San Francisco, California job with Kaiser Permanente - The Permanente Medical Group, Inc. -Northern California | 110442111)
2. Starting LA allergist salary is $314,000 (source: Allergist - Full Time Opportunity - Bakersfield, California job with Kaiser Permanente – Southern California Permanente Medical Group | 110408574)

Now, this is an incredible amount of money but as you consider your loans, your sacrifices, the VALUE you provide, and post-tax take home, it may not get you to the personal life goals you aspire to obtain.

Some additional resources I would recommend:
1. ACAAI career center - https://jobs.acaai.org/
2. Uni of CA salary - provides you with each academic salary - just search up their names - please do note that it only goes to 2022 which was in the midst of a pandemic AND jobs the physician did outside of their institution is NOT included - Compensation at the University of California: Annual Wage
3. California Paycheck Calculator - SmartAsset - punch in what a $300K take home salary would be in CA, it might surprise you

I will update as I speak with more individuals in the near future. Happy to help answer any other questions.
Thank you for this. This is really insightful!
 
Hi, this is a great question and I encourage everyone to think about your ultimate goal post-fellowship.

I am in the mist of interviewing as many people as I can to get as much information regarding post-fellow employment. Here is what I have gathered so far.

1. Work setting. There are academic vs private vs mixed careers. Mixed career is becoming more popular as academic does not pay enough money but private practice allergists miss being a part of academia (some love teaching, working with residents/fellows, or staying up-to-date on research stuff). Mixed practice is also getting a lot of private industry attention because it is easier to do clinical research in private practice (less red tape when it comes to IRB/grant vs academic institution). You can do that too in academic, but it is really tough financially because the institution takes a cut of your grant/funding. Within academic, there is basic science, clinical, and medical education tracks---which can vary highly in terms of your day-to-day and salary. For example, a basic scientist may have one half day of clinic where as a clinical will have 3-4 days. People in medical education tracks (+/- clinical) are usually the PD/APDs and they do it because they love teaching because....medical education unfortunately is not highly valued from a financial standpoint and they are paid less (love your PD/APDs, they truly are not there for the money).

2. Salary. This is perhaps the biggest difference. I am still learning this process but most people are paid by RUVs. An example that was provided for me was in private practice (PP), one single skin prick can be $5-10 and in academic, that same single skin prick is worth $0.60. So, if you do a full environmental panel in PP, it could get you $500 (50 pricks * 10) and in academic it will get you $30 (50 pricks * 0.60). Another example would be allergy shots. In PP you can make 2-3K annually per allergy shot in academia...depending on your institution...you may just get paid for writing the prescription...not the allergy shots themselves which is like....one RVU. Another example would be spirometry in PP can be $100, it could be $0.17 in academia.

Now, there is an "eat what you kill" culture in PP. You have to hustle. That is, you may or may not have a base salary in PP (which will likely be low) and your salary is highly dependent on how many patients you have on procedures/shots. There are PP allergists out there making close to one million a year but these are the alphas who own their own PP and they have been in the game for a long time. But, they started exactly where you were.

So why in the world would you stay in academia given such a huge difference in salary?
1) There are situations where you HAVE to stay: you love basic science (unless you can go into industry), you have PSLF, job opportunities in specific cities, you love teaching

A different pay system is Kaiser. Kaiser physicians are salaried and their take home is not RVU dependent. Your earning potential is limited to the salary plus some bonuses, but it will not likely get your to higher tax bracket near the >$500K.
1. Starting SF allergist salary is $278,000 (source: Allergist Opportunity- San Francisco, CA - San Francisco, California job with Kaiser Permanente - The Permanente Medical Group, Inc. -Northern California | 110442111)
2. Starting LA allergist salary is $314,000 (source: Allergist - Full Time Opportunity - Bakersfield, California job with Kaiser Permanente – Southern California Permanente Medical Group | 110408574)

Now, this is an incredible amount of money but as you consider your loans, your sacrifices, the VALUE you provide, and post-tax take home, it may not get you to the personal life goals you aspire to obtain.

Some additional resources I would recommend:
1. ACAAI career center - https://jobs.acaai.org/
2. Uni of CA salary - provides you with each academic salary - just search up their names - please do note that it only goes to 2022 which was in the midst of a pandemic AND jobs the physician did outside of their institution is NOT included - Compensation at the University of California: Annual Wage
3. California Paycheck Calculator - SmartAsset - punch in what a $300K take home salary would be in CA, it might surprise you

I will update as I speak with more individuals in the near future. Happy to help answer any other questions.
I agree with most of this. Your understanding/explanation of compensation could use some clarification.

RVUs are just a standardized way of assigning “value” to a procedure or encounter. Different payors ( CMS vs tricare/military vs commercial) will then apply a conversion factor or monetary value per RVU. For the sake of simplicity, let’s say cms gives $30 per rvu and BCBS gives $50 per rvu. You do a procedure that is 1 RVU, you get that amount paid. There are geographic modifiers and realistically there are negotiations with payors at a practice level about what they will pay for different things. RVUs are also separated into work or wRVUs and facility and non-facility RVUs. In a private practice, I don’t think in RVUs. I care about the money collected for the main things I bill for. It’s collections minus overhead. We definitely care about payor mix. RVUs on their own don’t matter, it’s how much per rvu, essentially.

In a large medical center or academic center, RVUs are often used. This helps mitigate cherry picking over payor mix by docs and puts productivity in a form that resembles a standardized metric. Docs are generally paid in some kind of base plus RVU bonus. Docs don’t care about collections in that scenario and they also don’t care about overhead, it’s just about volume and billing. It’s up to the institution to minimize overhead and maximize collections. IMO not a favorable set up for docs. So it’s all about how you negotiate. This is difficult if you haven’t practiced yet. I can look at my last couple years and tell you how productive I am (in dollars or RVUs, if that’s the language of the day). Then I can project how productive I will be and arrive at what I think is a fair compensation structure for whatever work you’re giving me.

I’m not sure what you heard about a skin test being reimbursed differently in PP vs Academics. Medicare is gonna pay the same amount to me for a skin test panel as it is to a doc at the university. I take the money, out comes the overhead, the rest is profit. In academics, the institution is getting the payment and taking out whatever they’ve decided or agreed to and then the rest goes in the doctors bucket. This is likely gonna been less money for the doctor in academics but it really depends how they negotiated with their employer. CMS is still cutting the same check for 80 skin pricks. There is some nuance about stuff done in an outpatient clinic vs say an allergist doing penicillin testing on the inpatient side of the facility but thats an insignificant portion of compensation. Physicians contracts will generally specify total vs wRVUs. wRVU is basically the part done by the doc and the remaining facility/nonfacility RVUs are meant for practice overhead.

In all fairness, I’m not in an RVU contract, so I could be incorrect in some of this. Would welcome any further correction or clarification.

At the end of the day, there’s no magic or mystery. It’s how much you pull in and how much you take home. Negotiations should stop immediately if they don’t offer complete transparency about what you pull in. They should also have a clear way of calculating what they take out of your total collections. Even if it’s not fair, it should be simple to understand. If someone just offers a salary, the devil is in how much are they expecting you to work. If they offer a bonus, it’s how obtainable is that bonus and how much are they keeping for themselves before they throw you some.
 
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I agree with most of this. Your understanding/explanation of compensation could use some clarification.

RVUs are just a standardized way of assigning “value” to a procedure or encounter. Different payors ( CMS vs tricare/military vs commercial) will then apply a conversion factor or monetary value per RVU. For the sake of simplicity, let’s say cms gives $30 per rvu and BCBS gives $50 per rvu. You do a procedure that is 1 RVU, you get that amount paid. There are geographic modifiers and realistically there are negotiations with payors at a practice level about what they will pay for different things. RVUs are also separated into work or wRVUs and facility and non-facility RVUs. In a private practice, I don’t think in RVUs. I care about the money collected for the main things I bill for. It’s collections minus overhead. We definitely care about payor mix. RVUs on their own don’t matter, it’s how much per rvu, essentially.

In a large medical center or academic center, RVUs are often used. This helps mitigate cherry picking over payor mix by docs and puts productivity in a form that resembles a standardized metric. Docs are generally paid in some kind of base plus RVU bonus. Docs don’t care about collections in that scenario and they also don’t care about overhead, it’s just about volume and billing. It’s up to the institution to minimize overhead and maximize collections. IMO not a favorable set up for docs. So it’s all about how you negotiate. This is difficult if you haven’t practiced yet. I can look at my last couple years and tell you how productive I am (in dollars or RVUs, if that’s the language of the day). Then I can project how productive I will be and arrive at what I think is a fair compensation structure for whatever work you’re giving me.

I’m not sure what you heard about a skin test being reimbursed differently in PP vs Academics. Medicare is gonna pay the same amount to me for a skin test panel as it is to a doc at the university. I take the money, out comes the overhead, the rest is profit. In academics, the institution is getting the payment and taking out whatever they’ve decided or agreed to and then the rest goes in the doctors bucket. This is likely gonna been less money for the doctor in academics but it really depends how they negotiated with their employer. CMS is still cutting the same check for 80 skin pricks. There is some nuance about stuff done in an outpatient clinic vs say an allergist doing penicillin testing on the inpatient side of the facility but thats an insignificant portion of compensation. Physicians contracts will generally specify total vs wRVUs. wRVU is basically the part done by the doc and the remaining facility/nonfacility RVUs are meant for practice overhead.

In all fairness, I’m not in an RVU contract, so I could be incorrect in some of this. Would welcome any further correction or clarification.

At the end of the day, there’s no magic or mystery. It’s how much you pull in and how much you take home. Negotiations should stop immediately if they don’t offer complete transparency about what you pull in. They should also have a clear way of calculating what they take out of your total collections. Even if it’s not fair, it should be simple to understand. If someone just offers a salary, the devil is in how much are they expecting you to work. If they offer a bonus, it’s how obtainable is that bonus and how much are they keeping for themselves before they throw you some.
Thank you for this! I am still learning this complicated reimbursement process. Your explanation of RVUs vs take home makes a lot of sense. I will say that the provider who gave me those examples does work in an RVU system and he has a mixed practice (owns a PP and then contracts it out with academic) so I do think he has a good direct comparison between the two. I am cognizant that it is just one person's practice experience. Like you, he did emphasize the institution overhead having a big impact on the reduction of the "take home" for the academic allergist. Your advice in the last paragraph is also noted and I'm hopeful potentially employers will be transparent.

Given that it is a thread on A&I fellowship application, I don't want to overtake it too much but one follow-up question that I hope will be helpful to others as well is: If you have experience with hiring people for PP, can you share some important factors in getting a PP job? Specifically, how does training program, geography, and/or personal connection influence the process.

Thank you!
 
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Personal connection > geography > training program. If you know someone at an institution or practice who likes you, that's going to trump anything. If they are hiring, you are probably first pick. If you are training in the same area you want a job then that likely results in some personal connections or at least some secondary connections...plus you kind of get to know the area and you hear things. Training program doesn't seem to matter as much for PP jobs. A/I isn't like a lot of other fields. There aren't particularly bad programs. We don't have some huge spread of random community no-name places. Pretty much all programs are at an academic center and the few "community" places ...like maybe national jewish, mayo, or scripps aren't really community programs. They are top notch institutions that just don't have "university of ____" in their names. I wouldn't discount personality or "fit" as an important aspect. There are allergists that I'm sure are fine doctors who I don't think would fit at all in my practice's culture. Academic centers probably do scrutinize a bit more on training programs. If you're a big research-oriented program, you are probably looking for candidates that trained in a research heavy setting and have a record that suggests they will continue that type of thing. Then again, there are academic centers that are looking to hire more clinically oriented allergist to basically just staff clinics and see patients.

Keep in mind, alot of this isn't first hand knowledge from me. I interviewed with one group. I knew where I wanted to go geographically and I sought this particular group out. I have friends or colleagues in A/I and I've heard their experiences in getting jobs. I've also seen how my training program went about hiring folks. But I didn't do a bunch of interviews and I never, not for one second, considered looking for a job in academics.
 
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5 more days till apps are out!!! Can't wait to have this app off my hands lol
 
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Finally submitted. Good luck guys :)
 
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I feel like that scene from Nemo when they jump in the ocean at the end of the movie in the little bags: "So now what guys?" Lmao
 
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7/17 - Medical College of Georgia IM
 
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Did a lot of people last year run into the issue of not being able to schedule an interview in time because all interview spots were taken? This happened with residency interviews and was horrible haha
 
The wait until that first interview is going to be rough🥲
 
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I agree with most of this. Your understanding/explanation of compensation could use some clarification.

RVUs are just a standardized way of assigning “value” to a procedure or encounter. Different payors ( CMS vs tricare/military vs commercial) will then apply a conversion factor or monetary value per RVU. For the sake of simplicity, let’s say cms gives $30 per rvu and BCBS gives $50 per rvu. You do a procedure that is 1 RVU, you get that amount paid. There are geographic modifiers and realistically there are negotiations with payors at a practice level about what they will pay for different things. RVUs are also separated into work or wRVUs and facility and non-facility RVUs. In a private practice, I don’t think in RVUs. I care about the money collected for the main things I bill for. It’s collections minus overhead. We definitely care about payor mix. RVUs on their own don’t matter, it’s how much per rvu, essentially.

In a large medical center or academic center, RVUs are often used. This helps mitigate cherry picking over payor mix by docs and puts productivity in a form that resembles a standardized metric. Docs are generally paid in some kind of base plus RVU bonus. Docs don’t care about collections in that scenario and they also don’t care about overhead, it’s just about volume and billing. It’s up to the institution to minimize overhead and maximize collections. IMO not a favorable set up for docs. So it’s all about how you negotiate. This is difficult if you haven’t practiced yet. I can look at my last couple years and tell you how productive I am (in dollars or RVUs, if that’s the language of the day). Then I can project how productive I will be and arrive at what I think is a fair compensation structure for whatever work you’re giving me.

I’m not sure what you heard about a skin test being reimbursed differently in PP vs Academics. Medicare is gonna pay the same amount to me for a skin test panel as it is to a doc at the university. I take the money, out comes the overhead, the rest is profit. In academics, the institution is getting the payment and taking out whatever they’ve decided or agreed to and then the rest goes in the doctors bucket. This is likely gonna been less money for the doctor in academics but it really depends how they negotiated with their employer. CMS is still cutting the same check for 80 skin pricks. There is some nuance about stuff done in an outpatient clinic vs say an allergist doing penicillin testing on the inpatient side of the facility but thats an insignificant portion of compensation. Physicians contracts will generally specify total vs wRVUs. wRVU is basically the part done by the doc and the remaining facility/nonfacility RVUs are meant for practice overhead.

In all fairness, I’m not in an RVU contract, so I could be incorrect in some of this. Would welcome any further correction or clarification.

At the end of the day, there’s no magic or mystery. It’s how much you pull in and how much you take home. Negotiations should stop immediately if they don’t offer complete transparency about what you pull in. They should also have a clear way of calculating what they take out of your total collections. Even if it’s not fair, it should be simple to understand. If someone just offers a salary, the devil is in how much are they expecting you to work. If they offer a bonus, it’s how obtainable is that bonus and how much are they keeping for themselves before they throw you some.

I have a wRVU contract so I can clarify. Haven't been on this board in a long time but good to see you're doing well. If I remember correctly, you and I shared a memorably odd interview day at a particular academic institution in southeast Michigan back in 2019. Unless you're someone else, in which case never mind.

I have no base salary, I just get paid a set dollar figure per wRVU I bill. It has nothing to do with what's collected, just what I bill, as long as I do it appropriately. My institution sets a "budget", or goal, so that my paycheck week to week is stable, and then I get a "bonus" at the end of the year if I go over that (it's not really a bonus, so I don't like to call it that really, I'm just getting paid later for the work I do now - like how a tax refund isn't actually a gift). If I don't meet my goal, I have a decrement that gets carried forward. I can then adjust my budget every year. Even though my paycheck is stable, technically in this model there is no such thing as paid vacation or sick leave. I get paid what I bill, period. There are some incentive bonuses that aren't related to billing, but these are small, less than 10% of my income.

The original poster saying that private practice gets paid $10 per prick while academics only $0.60 is kind of true but comparing apples to oranges. My institution does in fact bill insurers $10 for each prick, and in contrast I do in fact bill 0.01 wRVU for each prick, which comes out to less than a dollar in my pocket. But I don't think most clinics actually collect $10 for each prick, and in any case that's gross, not net. So yeah if the physician is truly in a private practice he owns himself, I guess he could theoretically say he gets paid $10 for each prick (if he can collect that), but he does then have to use that money to pay his staff and keep the lights on. So no, I don't think there are docs out there who are pocketing $500 for every environmental panel they do. If I actually netted that much for each prick I would literally have made $400k last year JUST FOR SKIN PRICKS ALONE AND NOTHING ELSE. That... doesn't happen. Sorry to say our specialty can be well-paid but not that well-paid. :)

Good luck all!
 
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I have a wRVU contract so I can clarify. Haven't been on this board in a long time but good to see you're doing well. If I remember correctly, you and I shared a memorably odd interview day at a particular academic institution in southeast Michigan back in 2019. Unless you're someone else, in which case never mind.

I have no base salary, I just get paid a set dollar figure per wRVU I bill. It has nothing to do with what's collected, just what I bill, as long as I do it appropriately. My institution sets a "budget", or goal, so that my paycheck week to week is stable, and then I get a "bonus" at the end of the year if I go over that (it's not really a bonus, so I don't like to call it that really, I'm just getting paid later for the work I do now - like how a tax refund isn't actually a gift). If I don't meet my goal, I have a decrement that gets carried forward. I can then adjust my budget every year. Even though my paycheck is stable, technically in this model there is no such thing as paid vacation or sick leave. I get paid what I bill, period. There are some incentive bonuses that aren't related to billing, but these are small, less than 10% of my income.

The original poster saying that private practice gets paid $10 per prick while academics only $0.60 is kind of true but comparing apples to oranges. My institution does in fact bill insurers $10 for each prick, and in contrast I do in fact bill 0.01 wRVU for each prick, which comes out to less than a dollar in my pocket. But I don't think most clinics actually collect $10 for each prick, and in any case that's gross, not net. So yeah if the physician is truly in a private practice he owns himself, I guess he could theoretically say he gets paid $10 for each prick (if he can collect that), but he does then have to use that money to pay his staff and keep the lights on. So no, I don't think there are docs out there who are pocketing $500 for every environmental panel they do. If I actually netted that much for each prick I would literally have made $400k last year JUST FOR SKIN PRICKS ALONE AND NOTHING ELSE. That... doesn't happen. Sorry to say our specialty can be well-paid but not that well-paid. :)

Good luck all!
A memorably odd interview, indeed. Only time I've really seen that level of obvious sadness in A/I fellows. Wonder how they're doing now.
 
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Did a lot of people last year run into the issue of not being able to schedule an interview in time because all interview spots were taken? This happened with residency interviews and was horrible haha
I’m heme onc and I was terrified about this too. Thankfully, the fellowship application process is a lot better.
 
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Is there some double dipping (abstracts as posters that were published added as both poster and pub) going on on the spreadsheet? 20+ pubs for most people on there already? what the heck lmao that has to be way more than the avg for allergy applicants
 
I have a wRVU contract so I can clarify. Haven't been on this board in a long time but good to see you're doing well. If I remember correctly, you and I shared a memorably odd interview day at a particular academic institution in southeast Michigan back in 2019. Unless you're someone else, in which case never mind.

I have no base salary, I just get paid a set dollar figure per wRVU I bill. It has nothing to do with what's collected, just what I bill, as long as I do it appropriately. My institution sets a "budget", or goal, so that my paycheck week to week is stable, and then I get a "bonus" at the end of the year if I go over that (it's not really a bonus, so I don't like to call it that really, I'm just getting paid later for the work I do now - like how a tax refund isn't actually a gift). If I don't meet my goal, I have a decrement that gets carried forward. I can then adjust my budget every year. Even though my paycheck is stable, technically in this model there is no such thing as paid vacation or sick leave. I get paid what I bill, period. There are some incentive bonuses that aren't related to billing, but these are small, less than 10% of my income.

The original poster saying that private practice gets paid $10 per prick while academics only $0.60 is kind of true but comparing apples to oranges. My institution does in fact bill insurers $10 for each prick, and in contrast I do in fact bill 0.01 wRVU for each prick, which comes out to less than a dollar in my pocket. But I don't think most clinics actually collect $10 for each prick, and in any case that's gross, not net. So yeah if the physician is truly in a private practice he owns himself, I guess he could theoretically say he gets paid $10 for each prick (if he can collect that), but he does then have to use that money to pay his staff and keep the lights on. So no, I don't think there are docs out there who are pocketing $500 for every environmental panel they do. If I actually netted that much for each prick I would literally have made $400k last year JUST FOR SKIN PRICKS ALONE AND NOTHING ELSE. That... doesn't happen. Sorry to say our specialty can be well-paid but not that well-paid. :)

Good luck all!
How much are you making on average and in what region, if you don't mind sharing
 
Is there some double dipping (abstracts as posters that were published added as both poster and pub) going on on the spreadsheet? 20+ pubs for most people on there already? what the heck lmao that has to be way more than the avg for allergy applicants
I can also speak on this having just gone through it for a research-heavy field. My GI/Cardio friends had a 3:1 ratio going. Example: ACG abstract gets accepted as a poster and automatically makes it to their supplemental journal. They listed it as a poster, the supplemental journal citation as a "pub", and once the manuscript got accepted to another crappy journal it was also listed as a pub, all 3 with slightly different titles.

Some IMGs will legitimately have 20+ real pubs because they did research before residency or were a "postdoc research fellow" before getting into residency. I wouldn't worry about it as long as you have a few things that made it to your conferences.
 
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I can also speak on this having just gone through it for a research-heavy field. My GI/Cardio friends had a 3:1 ratio going. Example: ACG abstract gets accepted as a poster and automatically makes it to their supplemental journal. They listed it as a poster, the supplemental journal citation as a "pub", and once the manuscript got accepted to another crappy journal it was also listed as a pub, all 3 with slightly different titles.

Some IMGs will legitimately have 20+ real pubs because they did research before residency or were a "postdoc research fellow" before getting into residency. I wouldn't worry about it as long as you have a few things that made it to your conferences.
thats good to know and makes more sense! I honestly thought my research was one of my strengths but went on the spreadsheet and was humbled very quickly by the IMGs 🤣 thanks for your insight!
 
thats good to know and makes more sense! I honestly thought my research was one of my strengths but went on the spreadsheet and was humbled very quickly by the IMGs 🤣 thanks for your insight!
Honestly, as an IMG it never feels like we're doing enough. We'll always be looked down upon. So, no worries at all.
 
I would think that would have gone to our emails? weird it only went to my eras inbox. hopefully interviews go to our emails or i wont see them right away which would be a disaster lol
I was thinking the same thing. I only checked cause you mentioned that here. No emails sent. Now we have to be paranoid and constantly check myeras?
 
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According to the google sheet, apparently Rush and Wisconsin have started to send out invites? Can anyone verify?
 
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